Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

How can I tell if I have a cold or the flu?

A cold and the flu have many of the same symptoms. But a cold is generally mild, while the flu tends to be more severe.

A cold often starts with feeling tired, sneezing, coughing and a runny nose. You may not have a fever or you may run a low fever - just a degree or two higher than usual. You may also have muscle aches, a scratchy or sore throat, watery eyes and a headache. As the cold worsens, your nasal mucus may turn from thin and watery to yellow and thick. Your symptoms may vary with each cold.
A cold usually lasts three or four days but can last up to 10 days. Many adults will have a least one or two colds a year, and most children will have five to eight. Colds are most common during months when people tend to gather indoors, such as in the winter.

The flu, which is a nickname for the influenza virus, starts suddenly and hits hard. Your fever may go as high as 40C (105F). You'll probably feel weak and tired, and have a dry cough, a runny nose, chills, muscle aches, severe headache and a sore throat. The fever may last for three to five days. After the flu goes away, you may still feel weak and tired or keep coughing for up to three weeks.
The flu is most common in winter and early spring. It often occurs in outbreaks. The flu virus changes often. About every 10 years it undergoes major changes, so that more severe outbreaks occur.

What causes colds and the flu?

Viruses. Over 100 different viruses can cause colds. The flu, on the other hand, is caused by just a few different viruses each year. That's why there's a vaccine for flu but not for colds.

What can I do to feel better?

	There's no cure for a cold or the flu. To feel better you can treat your symptoms while your body fights off the virus.
	Stay home and rest in bed, especially while you have a fever.
	Stop smoking and avoid second-hand smoke, which can make cold symptoms worse.
	Drink plenty of fluids like water and fruit juices. Try frozen flavored ice (Example: Popsicles). Fluids will help loosen mucus. Fluids are also important if you have a fever because fever can dry up your body's fluids, which can lead to dehydration.
	Drink hot tea with lemon and honey to soothe a sore throat and help loosen the mucus in your nose. Eating chicken soup can also help loosen the mucus.
	>Don't drink alcohol.
	Gargle with warm salt water a few times a day to relieve a sore throat (1 tsp. of salt in 1 cup of water). Throat spray or lozenges may also help relieve the pain.
	Suck on cough lozenges or hard candy to quiet a cough. Try to use ones low in sugar.
	If a child is too young to blow his or her own nose, you may try a suction bulb to remove the mucus. (A cold mist vaporizer may also help.)
	Use saline nose drops to help loosen mucus. These nose drops don't contain medicine, like decongestant nose drops do. Saline nose drops are like salt water and simply help moisten the tender skin in your nose (1/4 tsp. salt in 1 cup of water-cooled).

Should I take medicine for my cold or the flu?

Although Canadians spend more than $300 million a year on over-the-counter cold remedies, none of these products can cure a cold or make it end sooner. In fact, some of the side effects from the medicine could make you feel worse. Medicine can, however, help relieve some of your cold or flu symptoms. Check with your doctor before giving any medicine to children.
Many cold products contain more than one medicine. Products designed to treat more than one symptom may not be needed if you don't have all of those symptoms. Read labels carefully. Choose products that treat only the symptoms you have. (This may save money, too.)

Please note: According to Health Canada (December, 2008) you should NEVER give over-the-counter cough and cold medications, (like those described below) to children UNDER 6 years old.

If you do give these medications to children over 6 years old, be sure to measure the amounts very carefully. Follow the instructions on the package or bottle.

Guide to ingredients in over-the-counter cold and flu medicines

Analgesics relieve muscle aches and pains and reduce fever. Can be useful. Acetaminophen (some examples are Panadol, Tylenol), ASA (an example is aspirin), ibuprofen (some examples are Advil, Medipren, Motrin IB) may be taken. Warning: Children and teenagers shouldn't be given aspirin because it can cause Reye's syndrome if they have the flu or the chickenpox. Reye's syndrome is a rare illness that can lead to death.

Antihistamines block histamine, a substance that's released in response to allergies and causes a runny nose and sneezing. They probably aren't useful during a cold unless you also have allergies. Examples: chlorpehniramine, diphenhydramine, pheniramine, triporolidine. Warning: Often cause drowsiness.

Antitussives tell your brain to stop coughing. Useful for a dry cough. Don't take an antitussive if you're coughing up mucus (an example is dextromethorphan). Warning: Can make you sleepy; best used at night.

Expectorants help thin mucus so it can be coughed up more easily. Doctors disagree about whether they work (an example is guaifenesin). Drinking lots of fluid is one of the best ways to thin mucus.

Nasal decongestant sprays shrink nasal passages. Useful for a short period. Examples: ephedrine, phenylephrine, pseudoephedrine. Warning: Don't use more than every eight hours or for more than three days in a row. Using them longer can cause you to have even worse symptoms when you quit using them (rebound effect).

Oral decongestants shrink the nasal passages and reduce congestion. One of the most useful remedies for a cold. Examples: ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine. Warning: Can cause trouble sleeping, shakiness, fast heartbeat and raised blood pressure.

Why won't antibiotics help treat a cold or the flu?

Antibiotics don't work against viruses. So they can't cure a cold or the flu. But antibiotics can be helpful if you get an infection from bacteria, such as a sinus infection, an ear infection or pneumonia (an infection in the lungs).

What can I do to keep from catching colds and the flu?

The viruses that cause colds and the flu are spread through hand-to-hand contact and through the air in droplets released in sneezes and coughs. You don't catch a cold or the flu by getting wet or chilled.
The most important thing you can do to prevent catching a cold or the flu is to wash your hands often with soap and warm water, and avoid rubbing your eyes or nose. The number of viruses peak when cold symptoms begin, so you can pass viruses on before you develop cold symptoms. Use tissues instead of handkerchiefs to blow your nose so they can be thrown away.

Should I get a flu shot?

It's a very good idea to get a flu shot if you fall into any of the groups listed in the box below. People in these groups are more likely to have serious problems from the flu, such as pneumonia, or could spread the flu to people who could have serious problems from it.

People who should get flu shots

	People who live in nursing homes or other long-term care facilities
	Adults and children with chronic heart or lung disease
	Adults and children with diabetes, kidney disease, anemia or immune-system problems including AIDS
	Children on long-term aspirin therapy
	People over 65
	Health-care workers or family members who take care of people who could have problems if they got the flu

Warning: Don't get a flu shot if you're allergic to eggs.

People who don't fall into one of these groups are also sometimes interested in getting a flu shot. If you fall into one of these groups, or if you're interested in getting a flu shot anyway, talk to your doctor.
October and November are the best months to get a flu shot. In addition to flu shots, medications are now available that may help prevent some types of the flu or reduce the severity of symptoms if it's taken within 48 hours of getting sick.

Can the flu be dangerous?

There are deaths each year from the flu and complications that can be caused by the flu. About one of every 100 people who get the flu will have to go to the hospital. These are usually older people or people who have other diseases.

Should I see my doctor?

In most cases, you don't need to see your doctor when you have a cold. If you have any of these symptoms, call your doctor. If you think you have the flu, a medicine might help, but must be started within 48 hours of the start of symptoms.

See your doctor if you have

	A cold that lasts for more than 10 days
	Earache or fluid draining from your ear
	Severe pain in your face or forehead
	Temperature above 39C (102F)
	Shortness of breath
	Hoarseness, sore throat or a cough that won't go away
	Wheezing

Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.